Independent Medicines and Medical Devices Safety Review

Lord Patel Excerpts

Thursday 9th July 2020 Lords Chamber

[Lord Bethell]

I thank my noble friend for his comments and for his role in commissioning this important report. His point on the safety commissioner is extremely well made. I am not ruling out anything whatever, but we need time to study the report before we can make any commitments.

[Lord Patel (CB) [V]]

My Lords, I thank the noble Baroness, Lady Cumberlege, and her team for what is a hard-hitting report, and rightly so. Reading it, I felt anger and shame—anger that so many women patients were treated with such disdain and felt that they were not listened to; and ashamed that members of a profession I belong to showed such ignorance, arrogance, duplicity and callousness towards the very people who put trust in them. As a member of that profession, I apologise wholeheartedly to women who suffered and I hope that the profession takes heed of them. Much of the report draws on narratives from women, and I was struck by one who called herself

“an unsuspecting, unwilling participant in a cruel experiment”.

No patient should ever feel that. I hope this report is a wake-up call for the professional organisations too, to take charge and become more patient-focused, rather than professional-focused, and to deliver the care that patients deserve. I am a long-time supporter of the charity Epilepsy Action. It has welcomed the report and hopes that action will be taken soon, particularly for women and mothers in relation to sodium valproate. I support the questions asked of Ministers and I hope we will soon see action.

Covid-19 Update

Lord Patel Excerpts

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

I reassure my noble friend that anyone who has reason to believe that they may have been infected by the virus is eligible for the test. The resources we have put into testing are now enormous. There are nearly 300,000 tests a day. Those in Buckinghamshire who are too far away from the drive-in testing facility should apply for an at-home testing kit.

[Lord Patel (CB) [V]]

My Lords, I agree with much of what the noble Baronesses, Lady Thornton and Lady Brinton, had to say. In response to them, the Minister said the dashboard will provide data about the infection rate to local authorities and local healthcare. If that is so, I welcome it. Does that mean a change in policy towards greater involvement of local public health directors in managing this pandemic?

[Lord Bethell]

To be clear to the noble Lord, the dashboard was made available on 22 June. It has a very large amount of local information, including information from 111, hospitals and the test and trace programme. The analysis of the data will be enhanced using the latest technology in order to give the most granular information possible. Those enhancements will be rolled out very shortly.

Covid-19: Test and Trace App

Lord Patel Excerpts

Monday 22nd June 2020 Lords Chamber

[Lord Bethell]

My Lords, I completely endorse the noble Lord’s point. We have followed the principle of working in parallel in all cases possible. However, I should explain that pressure is incredibly intense, and one cannot focus on everything all the time. I understand the point that he makes, but I suggest that, at some points, one has to focus on one part at a time. That is what we have sometimes needed to do, but we have remained in contact with all players at all times.

[Lord Patel (CB) [V]]

My Lords, I have one question in two parts. First, in the event of a substantial increase in the number of new infections, what plans do the Government have to manage such an increase, and will they publish them? Secondly, what plans do they have to use antibody screening of the population?

[Lord Bethell]

My Lords, our plans for the winter are in development and I look forward to their publication. The noble Lord is entirely right to prioritise antibody screening. We have invested considerably in antibody testing from a number of suppliers, including Roche and Abbott. As he knows very well, the science remains ambiguous, but we are optimistic. That is why we are putting our best minds to understand it better, and we are world-leading in that respect.

Contact Tracing: Personal Privacy

Lord Patel Excerpts

Thursday 11th June 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, we are currently assessing the value of a specific Isle of Wight update and whether it would be worth while before we move on to issuing the full app. When we have finished that assessment, I would be glad to answer the questions asked by my noble friend.

[Lord Patel (CB) [V]]

My Lords, we need the tracking app to succeed. For this to happen, as has already been mentioned, the Government need to make sure that they are honest and transparent with the public to gain their trust. Can the Minister say when the Government will publish the performance data from the Isle of Wight trial? Further, can he confirm that the Government have been following their own code of conduct for data-driven technologies in healthcare and in the development of the app? For example, principle 4 refers to transparency and principle 10 refers to commercial models. Can he tell us what process will determine secondary uses of the data?

[Lord Bethell [V]]

My Lords, I can confirm that the Government have been following the code of conduct, as the noble Lord suggested. I am also hungry to publish the performance data. I can confirm that, so far, there have been 73,365 users of the Isle of Wight app, 53,490 of whom were on the Isle of Wight. The user experience has been largely benign, and we look forward to publishing fuller technical and user details shortly.

Covid-19: Cancelled Medical Operations

Lord Patel Excerpts

Wednesday 10th June 2020 Lords Chamber

[The Deputy Speaker (Baroness Garden of Frognal) (LD)]

We do not seem to be able to hear the noble Lord, Lord Patel.

[Lord Patel (CB) [V]]

My Lords, I have unmuted my microphone and I hope that my voice is coming through. I am sorry for the delay.

As the Minister will know, several million patients are on waiting lists for surgery. Given the increased levels of hygiene safety that will be required, it is inevitable that productivity will be down. This means that there will be a need for the prioritisation of cases. Does he agree that the professional organisations should draw up advisory guidelines for clinicians, rather than leaving it to the individuals?

[Lord Bethell [V]]

The noble Lord may be interested to know that, frustratingly, waiting lists have gone down rather than up, from 4.42 million in February to 4.32 million in March. This is an indication of people not coming forward for operations that they may need, and it is something that we are keen to address. However, we are putting the decision-making on how to handle the lists into the hands of local clinicians, who will use a combination of clinical need and waiting list times to make their decisions.

Covid-19: Response

Lord Patel Excerpts

Wednesday 3rd June 2020 Lords Chamber

[Lord Bethell]

My noble friend makes an incredibly valuable point and I completely share her concerns, but I will share two important points, if I may. First, we cannot avoid the fact that this disease has a 14-day incubation period. It is extremely tough to protect our borders from infection by a disease that may not be detectable, even at our borders, during that period. Secondly, while the peak is raging, additional infection from foreign visitors makes only a marginal difference, whereas at this stage, when we have worked so hard to get the prevalence down and reduce infectiousness, the threat of new infection from foreign visitors is higher. That is an irony that the CMO is fully aware of, but it is entirely right that we have brought in these measures. They are constantly under review. The impact on tourism and other industries is hugely regretted, but to rid the country of Covid they are proportionate.

[Lord Patel (CB)]

My Lords, I thank the Minister for repeating the Statement. Before I ask my question, let me say this: with the greatest respect to the Minister, if he thinks that no degree of racism exists in the NHS, I suggest that he speaks to those people from ethnic minorities who work in the NHS and see how they feel. I accept his comment that examination of what has happened hitherto is for another day, but we have to examine the current strategy for suppressing the virus, which we have not done successfully. In this regard, the latest initiative is the Government’s test and trace scheme. A great degree of transparency and trust will be required to make this a success. Can I ask the Minister: what matrix will the Government use to demonstrate the success of the project?

[Lord Bethell]

My Lords, I bow to the experience and wisdom of the noble Lord, Lord Patel, particularly in the matter of racism in the NHS. I would not for a moment suggest that there is no racism at all in the NHS—or any large organisation—and I deeply regret any bad experiences he may have had. The accusation, however, was of structural racism in the NHS, and that is what I push back against. The NHS as an organisation is not racist, and I reject the suggestion that it is.

As for the matrix of success, that is an extremely perceptive question, and a bloody tough one—exactly the kind I would expect from the noble Lord. To summarise, it is to reduce R: if we can get a lid on R0 and stop the index case from spreading the disease to more people, then Test and Trace will have succeeded.

Covid-19: Testing

Lord Patel Excerpts

Thursday 14th May 2020 Lords Chamber

[Lord Bethell]

My noble friend Lady Rawlings is entirely right: we all have an important role to play. There is good evidence that personal tracing by individuals of contacts within their networks has a powerful role to play in isolating those who might have been in contact with the virus. Defeating this virus will be the responsibility of everyone in the community; we cannot rely just on digital apps and central databases.

[Lord Patel (CB)]

My Lords, what evidence do the Government use to calculate the value of R0?

[Lord Bethell]

The noble Lord will know that we have set up one of the most ambitious surveys, conducted by the ONS, to study on a weekly basis a large number of viral and serological tests. Those are used by statisticians to understand both the prevalence and the spread of the disease. Figures for that are emerging—we now have three weeks-worth of figures. They are being published regularly and I would be glad to send the noble Lord a link to the relevant data.

Covid-19

Lord Patel Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

The noble Lord raises an issue that I remember was raised during discussions on the emergency Coronavirus Bill. It is my understanding that a generous and open-hearted view is taken on the treatment of those with irregular status in the UK. Now is clearly not the time to try to put in prison those who have irregular status. The precise arrangements escape me, but I would be glad to write to the noble Lord with a precise description.

[Lord Patel (CB)]

My Lords, the Minister mentioned in his Statement the introduction of app-based tracing of contacts, which others have already mentioned. At the same time, I assume that the Government will introduce serology testing and expand the current molecular testing. When will the Government publish the protocol for implementation of this, and how will the public be informed?

[Lord Bethell]

The noble Lord, Lord Patel, will be interested to read the details of our ONS serology tests that have begun earlier this week, which will be published in mid-May. These are surveillance tests and will provide us with the information that we need to understand how the epidemic is developing. At the right time we will also bring in mass serology testing. However, as the noble Lord will be aware, when prevalence rates are around 3%, 4% or 5%, as they seem likely to be, serology tests for managing the epidemic are not relevant yet.

Covid-19: Personal Protective Equipment

Lord Patel Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

I reassure my noble friend that we have been in daily and constant contact with the Turkish Government, who have behaved with good faith and in a supportive fashion throughout all our dealings. We are thankful to them for their involvement.

[Lord Patel (CB)]

Does the Minister agree that we have not done well when it comes to the delivery and availability of PPE? As yet, nobody has said sorry to anybody for that. Does he think that somebody should? If I may repeat and slightly rephrase the question asked by the noble Baroness, Lady Smith, at the door of which Cabinet Minister does the buck stop?

[Lord Bethell]

I am not sure that I agree with the analysis of the noble Lord. No one could have anticipated the huge demand for PPE not just in the NHS and care homes but in other workplaces. This is a global phenomenon. The chase for PPE is difficult in all countries around the world. Britain is not alone in struggling with this. I do not think now is the time for apologies; now is the time for delivering PPE, and that is what this Government are focused on doing.

Covid-19: Removal of Restrictions

Lord Patel Excerpts

Tuesday 21st April 2020 Lords Chamber

[The Lord Speaker (Lord Fowler)]

Lord Mackay of Clashfern. No? Okay, we will go on. Lord Patel.

[Lord Patel (CB)]

Noble Lords cannot see me, but I hope they can hear me. One of the five conditions the Government have set themselves before any changes will be made to the current lockdown is that they will have to be confident that there will not be a second wave of infection. What scientific evidence will the Government need in support of this decision, and what role will population-based serology testing play in this decision?

[Lord Bethell]

The noble Lord, Lord Patel, asks an incredibly perceptive question. The ultimate decisions will be made by the CMO, who, as noble Lords know, has enormous experience in this exact area. Serology tests play an extremely important role in this by giving an indication of the number of antibodies there are, whether people have a degree of immunity and therefore a sense of how far the virus has spread through the community. However, we are aware of reports that there are recurrences of the virus in people who have emerged and recovered. That creates a great sense of concern around our serology tests.